Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Diabetologia. 2013 Aug;56(8):1689-95. doi: 10.1007/s00125-013-2936-7. Epub 2013 May 23.
AIMS/HYPOTHESIS: The primary aim of the study was to investigate the risk of developing gestational diabetes in women who were exposed to tobacco smoke in utero. Secondary aims were to assess the risk of obesity and non-gestational diabetes.
Data were retrieved from the Medical Birth Register of Sweden for women who were born in 1982 (when smoking data were first registered) or later and who had given birth to at least one child; 80,189 pregnancies were included. The associations between in utero smoking exposure (three categories: non-smokers, 1-9 cigarettes/day [moderately exposed] and >9 cigarettes/day [heavily exposed]) and subsequent gestational diabetes (n = 291), non-gestational diabetes (n = 280) and obesity (n = 7,300) were assessed.
The adjusted ORs (aORs) of gestational diabetes were increased among women who were moderately (1.62, 95% CI 1.24, 2.13) and heavily (1.52, 95% CI 1.12, 2.06) exposed. The corresponding aORs of obesity were 1.36 (95% CI 1.28, 1.44) and 1.58 (95% CI 1.48, 1.68), respectively. A reduced OR for non-gestational diabetes was seen in the offspring of heavy smokers (aOR 0.66, 95% CI 0.45, 0.96).
CONCLUSIONS/INTERPRETATION: Women exposed to smoking during fetal life were at higher risk of developing gestational diabetes and obesity.
目的/假设:本研究的主要目的是调查宫内暴露于烟草烟雾的女性患妊娠期糖尿病的风险。次要目的是评估肥胖和非妊娠期糖尿病的风险。
从瑞典医学出生登记处检索了数据,包括 1982 年(首次登记吸烟数据)或以后出生且至少生育过一个孩子的女性;共纳入 80189 例妊娠。评估了宫内吸烟暴露(三组:不吸烟者、每天 1-9 支香烟[中度暴露]和>9 支香烟/天[重度暴露])与随后发生的妊娠期糖尿病(n=291)、非妊娠期糖尿病(n=280)和肥胖(n=7300)之间的关系。
中度(1.62,95%可信区间 1.24,2.13)和重度(1.52,95%可信区间 1.12,2.06)暴露的女性患妊娠期糖尿病的调整比值比(aOR)增加。肥胖的相应 aOR 分别为 1.36(95%可信区间 1.28,1.44)和 1.58(95%可信区间 1.48,1.68)。重度吸烟者后代中非妊娠期糖尿病的 OR 降低(aOR 0.66,95%可信区间 0.45,0.96)。
结论/解释:胎儿期暴露于吸烟的女性患妊娠期糖尿病和肥胖的风险更高。